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Postburn rehabilitation and improvement of body image 烧伤后康复与身体形象的改善
Pub Date : 2021-01-01 DOI: 10.4103/ijb.ijb_11_22
Vijay Kumar
Improvement in quality of life and optimum functional recovery after burn injury is the final goal of burn care. After major burn injuries, look (body image) and functionality changed a lot. How a person perceive himself or herself, how confident about his/her looks, and how much confident about his/her body appearance are collectively known as body image. Severe distress is present in 30% of burn survivors and perceives their distorted body image after their first hospitalization. Pre- and postoperative physiotherapy and occupational therapy provide alternative ways for these problems of burn patients. Almost everyone has certain degree of changes in their recovery phase, but most of them get used to the change in their appearance over the time.
烧伤后提高生活质量和最佳功能恢复是烧伤护理的最终目标。严重烧伤后,外观(身体形象)和功能发生了很大变化。一个人如何看待自己,对自己的外表有多自信,以及对自己的外貌有多自信统称为身体形象。30%的烧伤幸存者存在严重的痛苦,并在第一次住院后感觉到他们扭曲的身体形象。术前和术后的物理治疗和职业治疗为烧伤患者的这些问题提供了替代方法。几乎每个人的恢复阶段都有一定程度的变化,但随着时间的推移,他们中的大多数人都习惯了外表的变化。
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引用次数: 0
Clinicoepidemiological profile of thermal burn injuries and its mortality risk factors in a tertiary care center in Uttarakhand 北阿坎德邦一家三级保健中心热烧伤的临床流行病学特征及其死亡危险因素
Pub Date : 2021-01-01 DOI: 10.4103/ijb.ijb_33_21
P. Verma, H. Saxena, S. Kala, Mohit M. Singh, Komal Tripathi
Introduction: Burns are a major burden to the society in terms of lives lost, treatment costs, and postburn deformities. This study aims to identify the incidence, causes of burns, associated risk factors, and mortality in a tertiary care center in Uttarakhand. Patients and Methods: This study was an observational study conducted from October 2018 to April 2021 at a tertiary care center in Uttarakhand. It includes the patients with thermal burns who were admitted in the burns unit of the hospital. The interrelationship between various risk factors and mortality was studied. Results: A total of 247 patients were included in the study. Males outnumbered females constituting 55.47% of the population. Most of the patients were of age group 21–40 years and were from rural backgrounds, belonging to lower socioeconomic class. The literacy rate was 76.52%. Farming was the predominant occupation. Major cause of burns was flame burns with second-degree burns being the most common. Accidental burns were common, and mostly (39.68%) patients sustained burns with total burn surface area (TBSA) <25%. The mortality rate was 11.34%. Majority (56.68%) of the patients belonged to Class IV socioeconomic class (modified BG Prasad classification). Conclusions: Young males of rural background and low socioeconomic strata were the most common victim of burn injuries. The majority of cases were accidental thermal burns. The mortality rate was high in patients with TBSA >60%, third-degree burns and housewives. Appropriate measures need to be taken regarding the education of the public for prevention of burns and improvement in healthcare to decrease the incidence and improve the outcome of burn patients.
引言:烧伤是社会的主要负担,包括生命损失、治疗费用和烧伤后畸形。本研究旨在确定北阿坎德邦一家三级护理中心的烧伤发生率、原因、相关风险因素和死亡率。患者和方法:这项研究是一项观察性研究,于2018年10月至2021年4月在北阿坎德邦的一家三级护理中心进行。其中包括医院烧伤科收治的热烧伤患者。研究了各种危险因素与死亡率之间的相互关系。结果:本研究共纳入247例患者。男性数量超过女性,占总人口的55.47%。大多数患者年龄在21-40岁之间,来自农村,属于较低的社会经济阶层。识字率为76.52%,农业是主要职业。烧伤的主要原因是火焰烧伤,其中二度烧伤最为常见。意外烧伤是常见的,大多数(39.68%)患者持续烧伤,总烧伤面积(TBSA)为60%,三度烧伤和家庭主妇。需要采取适当措施对公众进行预防烧伤的教育和改善医疗保健,以降低烧伤患者的发病率并改善其预后。
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引用次数: 1
Resurfacing autograft-harvested donor sites with cadaver allograft in surgical management of extensive deep burns – A genesis of idea and its possible applications 自体移植供体在大面积深度烧伤外科治疗中的应用——想法的起源及其可能的应用
Pub Date : 2021-01-01 DOI: 10.4103/ijb.ijb_17_21
Narendra S. Mashalkar
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引用次数: 0
Major COVID-19-positive burns treated successfully 成功治疗严重COVID-19阳性烧伤
Pub Date : 2020-01-01 DOI: 10.4103/ijb.ijb_21_20
V. Bhatia, Kena Patel, Sruja Narola, Ranjit Zapadiya, A. Parikh
Extensive burns are severe form of trauma causing a great threat to life. Approximately 300,000 deaths is attributed to burns annually, majority (>95%) of which occur in developing countries. Survival rate of patients decreases as the rate of burn increases. Coronavirus disease (COVID-19) pandemic has affected all the communities worldwide. It has strong infectivity and high transmission rate. When treating corona-virus-infected burns patients, prevention of cross infection to health workers becomes of utmost importance. Here, authors present a case of extensive burns along with COVID-19 infection, the precautions taken to prevent infection among health workers and protocols followed for management. The patient was treated over a span of 75 days where the patient was cured of COVID-19 in 21 days and underwent two surgeries with homograft and autograft application. Multidisciplinary approach with strict protocols of safety and vigilant monitoring is key to successful management.
大面积烧伤是一种严重的创伤,对生命构成极大威胁。每年约有30万人死于烧伤,其中大多数(95%)发生在发展中国家。随着烧伤率的增加,患者的存活率降低。冠状病毒病(COVID-19)大流行已影响到全球所有社区。传染性强,传播率高。在治疗冠状病毒感染的烧伤患者时,预防卫生工作者的交叉感染至关重要。在这里,作者介绍了一例大面积烧伤合并COVID-19感染的病例,以及为防止卫生工作者感染所采取的预防措施和遵循的管理方案。患者接受了75天的治疗,在21天内治愈了新冠肺炎,并接受了同种移植物和自体移植物的两次手术。多学科方法,严格的安全协议和警惕监测是成功管理的关键。
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引用次数: 0
Epidemiological analysis of chemical burns: Does it reflect any change in trends? 化学烧伤的流行病学分析:它是否反映了趋势的变化?
Pub Date : 2020-01-01 DOI: 10.4103/ijb.ijb_33_20
S. Sharma, Piyush Thayal, P. Arumugam
Introduction: Chemical burns constitute small proportion of cases among the total admissions due to burn injuries. The spectrum of severity of illness can vary from mild injuries to life-threatening trauma. In the Indian scenario, the incidence of chemical burns has been reported to be 2.25%–2.4% of total burn admissions. We decided to analyze the epidemiological trends in a tertiary care center from 2013 to 2018 and observe if there has been any shift in the trends. Materials and Methods: A retrospective chart review of all burn victims who attended our burns casualty in V. M. M. C and Safdarjung Hospital, New Delhi, India, between January 2013 and December 2018, was carried out. Results: During the study period of 6 calendar years from 2013 to 2018, a total of 142 patients of chemical burns attended the hospital, with 47 of them requiring admission. The chemical burns accounted for 0.45% of the total burn patient's attendance. Male dominance was noted with 64% of patients being males. Nearly 59% of the chemical burn patients were from 21 to 40-year age group. Accidental chemical burns accounted for maximum cases. It was observed that acid burns have decreased in comparison to the initial 3 years. Conclusion: Downward trend in the incidence of overall chemical burns was noted. Acid burns decreased with simultaneous increase in alkali burns. The study period coincided with the Supreme Court's verdict with the formulation of guidelines on sale of acids in 2013 and this could be the major factor in declining trends of acid burns.
简介:化学烧伤在因烧伤入院的总人数中所占比例很小。疾病的严重程度可以从轻度损伤到危及生命的创伤不等。据报道,在印度的情况下,化学烧伤的发生率为烧伤总入院人数的2.25%-2.4%。我们决定分析2013年至2018年三级护理中心的流行病学趋势,并观察趋势是否有任何变化。材料和方法:对2013年1月至2018年12月期间在印度新德里V.M.M.C和Safdarjung医院就诊的所有烧伤患者进行了回顾性图表审查。结果:在2013年至2018年的6个日历年的研究期间,共有142名化学烧伤患者到医院就诊,其中47人需要入院治疗。化学烧伤占烧伤病人就诊总数的0.45%。男性占优势,64%的患者为男性。近59%的化学烧伤患者年龄在21至40岁之间。意外化学灼伤的案例最多。据观察,与最初的3年相比,酸烧伤有所减少。结论:化学烧伤总发生率呈下降趋势。酸烧伤减少,同时碱烧伤增加。研究期间恰逢最高法院2013年制定酸销售指南的裁决,这可能是酸烧伤趋势下降的主要因素。
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引用次数: 0
Burn management during COVID-19 era: An overview COVID-19时代烧伤管理:概述
Pub Date : 2020-01-01 DOI: 10.4103/ijb.ijb_7_21
Vijay Kumar
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引用次数: 0
The effect of rhythmic deep breathing on pain and anxiety in patients with burns 节律性深呼吸对烧伤患者疼痛和焦虑的影响
Pub Date : 2020-01-01 DOI: 10.4103/ijb.ijb_5_20
A. Iyer, Suroshree Mitra, Rachana P. Dabadghav
Context: Patients with burns suffer from physical (pain) and psychosocial (anxiety) sequelae due to the burns wounds and mobilization activities. Deep breathing is a simple intervention to manage pain and anxiety in various conditions. Data concerning the effect of breathing on burns patients are limited. In order to add to this information, this study was undertaken on burns patients. Aims and Objectives: The aim was to study the effect of rhythmic deep breathing on pain and anxiety in patients with burns. Methods: This study followed an experimental, pretest–posttest design. A single group of twenty patients in the age group of 5–70 years who had suffered various types of burns to some or all parts of the body were recruited from a tertiary care center in Pune, India. With institutional approval and written consent, deep breathing technique was taught to the patients. Pretest and posttest scores of pain visual analog scale (VAS), anxiety (VAS), and anticipatory anxiety pain anxiety symptom scale were collected in the period from October 2019 to November 2019. Results: Significant change (P = 0.00) was observed in the mean pain, anxiety, and anticipatory anxiety scores over time. Conclusion: Rhythmic deep breathing can significantly help to decrease pain and anxiety in patients with burns.
背景:烧伤患者由于烧伤创面和活动而遭受身体(疼痛)和社会心理(焦虑)后遗症。深呼吸是一种简单的干预,可以在各种情况下控制疼痛和焦虑。有关呼吸对烧伤患者影响的数据有限。为了补充这一信息,本研究是在烧伤患者中进行的。目的和目的:目的是研究有节奏的深呼吸对烧伤患者疼痛和焦虑的影响。方法:本研究采用实验前测后测设计。从印度浦那的一个三级保健中心招募了年龄在5-70岁之间的20名身体部分或全部遭受不同类型烧伤的患者。经机构批准和书面同意,向患者传授深呼吸技巧。收集2019年10月至2019年11月疼痛视觉模拟量表(VAS)、焦虑量表(VAS)和预期焦虑疼痛焦虑症状量表的前测和后测评分。结果:随着时间的推移,平均疼痛、焦虑和预期焦虑评分发生了显著变化(P = 0.00)。结论:有节奏的深呼吸能显著减轻烧伤患者的疼痛和焦虑。
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引用次数: 4
Coverage of exposed pericardium with a lateral thoracic artery perforator flap 胸廓外动脉穿支皮瓣覆盖外露心包
Pub Date : 2020-01-01 DOI: 10.4103/ijb.ijb_16_20
V. Bhatia, Pradnya Sarwade, Pranav Thusay, S. Mehta, Nirav Visavadia
Electricity is an indispensable part of the society that we live in, depending on it from household appliances to farms and industries. Electrical burn injuries, although form a small proportion of the total burn cases, pose significant challenges in their management due to their varied manifestations and the high associated morbidity and mortality. Most high voltage electrical injuries are work related. The entry wounds are most commonly seen over the upper extremities, whereas the exit wounds are seen over the lower extremities. The thorax presents an uncommon site for an entry wound. In this case report, the authors present one such case of electrical injury with an entry wound over the thorax presenting as a left parasternal defect that was debrided and covered successfully with a lateral thoracic artery perforator-based flap from the lateral chest wall.
电力是我们生活的社会不可或缺的一部分,从家用电器到农场和工业都依赖电力。电烧伤虽然在总烧伤病例中只占很小的比例,但由于其表现多样,相关的发病率和死亡率很高,对其管理提出了重大挑战。大多数高压电气伤害与工作有关。入口伤口最常见于上肢,而出口伤口常见于下肢。胸部是一个不常见的入口伤口部位。在本病例报告中,作者提出了一例这样的电损伤病例,胸部有一个进入伤口,表现为左侧胸骨旁缺损,该缺损已被清除,并用胸外侧壁的胸外侧动脉穿支皮瓣成功覆盖。
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引用次数: 0
Understanding the role of serum lactate as an end point in burn resuscitation 了解血清乳酸作为烧伤复苏终点的作用
Pub Date : 2020-01-01 DOI: 10.4103/ijb.ijb_1_20
N. D’souza, A. Kujur, D. Rajeswari
Context: Fluid resuscitation plays a significant role in burns treatment. Inappropriate resuscitation impacts morbidity and mortality. Urine output (UO), the current gold standard, alone, is not an adequate end point of fluid resuscitation in burns. Hence, we studied the utility of serum lactate levels as a reliable marker and end point of resuscitation. Aims: (a) To understand the role of serum lactate levels in burns as end point in acute burn resuscitation and (b) To assess its sensitivity and specificity. Settings and Design: Tertiary care hospital, urban setting, and cross-sectional study. Subjects and Methods: The study was done from September 2015 to July 2017. Sixty-four patients with thermal burns were included. Serum lactate levels were recorded at arrival, 8 h, 16 h, 24 h, and 48 h interval postburn incident. Hourly UO heart rate and mean arterial pressure were recorded for the outcome measures. Statistical Analysis Used: Chi-square test and nonparametric Mann–Whitney U-test. P ≤ 0.05 was considered statistically significant. Results: (a) The initial serum lactate levels at presentation were directly proportional to: The total body surface area and percent deep component of burns sustained Delay in starting resuscitation. b. Time taken for serum lactate levels to normalize is directly proportional to initial serum lactate level. At 16 h, serum lactate showed (94%) specificity, (53%) sensitivity, and at 48 h (85%) sensitivity, (44%) specificity. Conclusions: Serum lactate levels can help to monitor the adequacy of fluid resuscitation in burns. Serum lactate and UO, both, should be taken into consideration to determine the end point of resuscitation.
背景:液体复苏在烧伤治疗中起着重要作用。不适当的复苏影响发病率和死亡率。尿量(UO),目前的金标准,单独是不够的终点液体复苏烧伤。因此,我们研究了血清乳酸水平作为复苏的可靠标志和终点的效用。目的:(a)了解血清乳酸水平作为急性烧伤复苏终点的作用;(b)评估其敏感性和特异性。环境和设计:三级保健医院、城市环境和横断面研究。研究对象与方法:研究于2015年9月至2017年7月完成。纳入64例热烧伤患者。记录到达时、烧伤后8小时、16小时、24小时和48小时的血清乳酸水平。记录每小时UO心率和平均动脉压作为结果测量。统计分析方法:卡方检验和非参数Mann-Whitney u检验。P≤0.05认为有统计学意义。结果:(a)出现时的初始血清乳酸水平与:总体表面积和烧伤深度成分百分比持续复苏延迟时间成正比。b.血清乳酸水平正常化所需的时间与初始血清乳酸水平成正比。16 h时,血清乳酸的特异性为94%,敏感性为53%;48 h时,敏感性为85%,特异性为44%。结论:血清乳酸水平有助于监测烧伤患者液体复苏的充分性。血清乳酸和UO均应考虑,以确定复苏终点。
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引用次数: 0
Prevalence and profile of persons with burn injuries in rural field practice area of Rajarajeswari Medical College and Hospital, Bengaluru 班加罗尔拉贾拉杰斯瓦里医学院和医院农村野外执业区烧伤患者的患病率和概况
Pub Date : 2020-01-01 DOI: 10.4103/ijb.ijb_6_20
A. Subramanian, S. Manjunatha
Background: Burn injury is one of the common medical emergencies admitted to any hospital and is an important public health problem globally. Although most burn injuries are preventable, the general lack of safety consciousness, lack of knowledge on first aid measures, compounded by the absence of organized burn care at primary and secondary health-care level, hinder the curbing of this preventable problem. Objectives: (a) To estimate the prevalence of burn injuries in the rural field practice area of RajaRajeswari Medical College and (b) To determine the sociodemographic profile of burn injury victims and describe the burn injuries in the rural field practice area of RajaRajeswari Medical College. Subjects and Methods: A community-based cross-sectional study was carried out among 1220 randomly selected participants in the rural area using a semi-structured, pretested questionnaire. Data were analyzed adopting descriptive statistics, univariate and multivariate statistical techniques using the Statistical Package for the Social Sciences version 22. Results: The prevalence of burn injuries was found to be 9.5% in the present study. Logistic regression analysis showed that various sociodemographic characteristics of participants such as age, type of family, educational status, and socioeconomic status had a statistically significant association with burn injuries. Conclusion: The prevalence of burn injuries was 9.5% among the study participants. There existed a statistically significant association between burn injuries and various sociodemographic determinants.
背景:烧伤是任何医院收治的常见急症之一,是全球性的重要公共卫生问题。虽然大多数烧伤是可以预防的,但普遍缺乏安全意识,缺乏急救措施知识,再加上初级和二级卫生保健一级缺乏有组织的烧伤护理,阻碍了对这一可预防问题的控制。目标:(a)估计RajaRajeswari医学院农村野外执业区烧伤的发生率;(b)确定烧伤受害者的社会人口特征,并描述RajaRajeswari医学院农村野外执业区烧伤的情况。研究对象和方法:采用半结构化预测问卷,在农村地区随机抽取1220名参与者,开展基于社区的横断面研究。数据分析采用描述性统计、单变量和多变量统计技术,使用社会科学统计软件包第22版。结果:本研究烧伤发生率为9.5%。Logistic回归分析显示,年龄、家庭类型、教育程度、社会经济地位等各种社会人口学特征与烧伤有统计学显著相关。结论:研究对象烧伤发生率为9.5%。烧伤与各种社会人口统计学决定因素之间存在统计学上显著的关联。
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引用次数: 0
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Indian journal of burns
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